Stanford Neuromodulation Therapy (SNT): A Double-Blind Randomized Controlled Trial.

Active treatment produced a greater reduction in depression ratings than sham in this small trial. The findings concern a specific intensive, personalized protocol.

Cole EJ, Phillips AL, Bentzley BS, Stimpson KH, Nejad R, Barmak F, Veerapal C, Khan N, Cherian K, Felber E, Brown R, Choi E, King S, Pankow H, Bishop JH, Azeez A, Coetzee J, Rapier R, Odenwald N, Carreon D, Hawkins J, Chang M, Keller J, Raj K, DeBattista C, Jo B, Espil FM, Schatzberg AF, Sudheimer KD, Williams NR.
The American journal of psychiatry · Publication date: 2021-10-29
Added to site: 2026-09-09
DOI: 10.1176/appi.ajp.2021.20101429

Publication date recorded by Europe PMC; online and issue dates may differ.

Modalities

TMS, rTMS

Clinical focus

Depression

Population

Patients with treatment-resistant depression

Sample

32 enrolled; 29 received treatment: 14 active, 15 sham

Intervention / method

Five-day accelerated, high-dose intermittent theta-burst stimulation with individualized MRI targeting

Comparator

Sham stimulation

Clinician summary

At four weeks, mean MADRS reduction was 52.5% with active treatment and 11.1% with sham. This randomized result should not be confused with remission estimates from earlier open-label work.

How to interpret the findings

Small interim trial; longer-term durability and comparisons with other active treatments require further evidence.

Equipment and disclosures

Equipment details were not verified from the reviewed abstract.

Funding and competing-interest disclosures were not verified from the reviewed abstract.

Related evidence

Compare findings from the same clinical area, including mixed results.

• Repetitive transcranial magnetic stimulation (rTMS) combined with antidepressant pharmacotherapy for depression: state-dependent mechanisms, clinical evidence, and translational challenges · Positive with limitations
• Transcranial low voltage pulsed electromagnetic fields in patients with treatment-resistant depression. · Positive with limitations
• The effects of swLORETA Z-score neurofeedback for patients comorbid with major depressive disorder and anxiety symptoms. · Positive with limitations
• Effects of swLORETA Z-score neurofeedback in Z-coherence of the fronto-limbic circuit in patients with major depressive disorder. · Positive with limitations
• Clinical Efficacy of High-Frequency Deep Repetitive Transcranial Magnetic Stimulation in the Treatment of Depression and the Predictive Role of Baseline Triglyceride Levels: A Randomized Sham-Controlled Trial. · Positive with limitations
• TMS-EEG Correlate of Suicidal Ideation in Individuals with Depression: A Multi-Site Synthesis. · Positive with limitations
• Motor Cortex rTMS Alleviates Pain and Comorbid Depression After Spinal Cord Injury with a Correlate in M1 Intracortical Inhibition. · Positive with limitations
• A PRISMA-compliant Systematic Review and Meta-Analysis of the Late Positive Potential in Depression. · Positive with limitations
• Feasibility, tolerability, and preliminary effectiveness of an accelerated bilateral intermittent theta-burst stimulation protocol in adults with posttraumatic stress disorder and comorbid depressive disorder following mild traumatic brain injury. · Positive with limitations
• Accelerated TMS is associated with changes of subgenual cingulate-default mode network coupling in depression: an observational 7 Tesla fMRI study. · Mixed
• Identifying poor responders to repetitive transcranial magnetic stimulation using structural brain networks. · Positive with limitations
• Theta burst stimulation with 80 and 120% resting motor threshold do not differ in their antidepressant efficacy: a retrospective analysis. · Positive with limitations
• TMS-Evoked Cortical Reactivity Signatures as a Multidimensional Biomarker of Depression: A TMS-EEG Meta-Analysis from Diagnosis to Prognosis. · Positive with limitations
• The effects of cognitive-behavioural therapy (CBT) on heart rate variability (HRV) in people with depression and/or anxiety disorders: A systematic review and meta-analysis · Positive with limitations